地佐辛预处理对依托咪酯脂肪乳剂诱导肌阵挛和苏醒质量的影响  

Effect of pretreatment with dezocine on etomidate lipid emulsion induced myoclonus and awakening quality

作　　者：吴文华[1] 周脉涛[1] 

机构地区：[1]中国人民解放军第101医院麻醉科,江苏省无锡市214044

出　　处：《职业与健康》2012年第23期3007-3008,共2页Occupation and Health

摘　　要：目的探讨地佐辛预处理对依托咪酯脂肪乳剂诱导肌阵挛和苏醒质量的影响。方法选择100例择期在全身麻醉下行腹腔镜胆囊切除术患者,采用随机数字表法,将患者随机分为试验组和对照组各50例。两组诱导均采用咪达唑仑0.05 mg/kg、芬太尼0.3μg/kg、依托咪酯脂肪乳0.3 mg/kg、维库溴铵0.1 mg/kg,试验组在诱导前15 min缓慢静脉注射地佐辛5 mg(生理盐水稀释至10 ml),观察两组诱导后肌阵挛发生率和苏醒时间、拔管时间、躁动评分。结果试验组肌阵挛发生率为18.00%,明显低于对照组的44.00%,差异有统计学意义(χ2=7.90,P<0.01)。试验组和对照组的苏醒时间分别为(11.08±1.80)min和(10.24±1.27)min;拔管时间分别为(15.16±2.39)min和(13.96±2.03)min,但差异均无统计学意义(P>0.05)试验组躁动评分为(1.04±0.89),显著低于对照组的评分(1.64±0.99),差异均有统计学意义(P<0.05)。结论地佐辛预处理能有效防治依托咪酯脂肪乳剂诱导肌阵挛和苏醒期躁动,值得临床使用。[Objective]To investigate the effect of pretreatment with dezocine etomidate lipid emulsion induced myoclonus and awakening quality.[Methods]100 patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomly divided to the experimental group and control group,50 cases in each group.Anesthesia induction was done with midazolam 0.05 mg/kg,fentanyl 0.3 μg/kg,etomidate lipid emulsion 0.3 mg/kg,and vecuronium 0.1 mg/kg in two groups.While the experimental group received dezocine 5 mg（diluted with normal saline to 10ml） 15 min before the induction.The incidence of myoclonus,awakening time,extubation time and restlessness score（RS score） were observed in two groups.[Results]The incidence of myoclonus in the experimental group（18.00%） was lower than that in the control group（44.00%） significantly（χ2=7.90,P0.01）.The awakening time and extubation time were（11.08±1.80） min,（10.24±1.27） min and（15.16±2.39） min and（13.96±2.03） min in the experimental group and the control group,respectively.The difference between two groups was not statistically significant（P0.05）.RS score in the experimental group（1.04±0.89） was less than that in the control group（1.64±0.99） significantly（P0.05）.[Conclusion]Pretreatment with dezocine before anesthesia induction can effectively prevent etomidate lipid emulsion induced myoclonus and awakening agitation,which is worth popularizing in clinic.

关 键 词：地佐辛 预处理 依托咪酯脂肪乳剂 肌阵挛 苏醒质量 

分 类 号：R614.2[医药卫生—麻醉学]